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Home My WebLink About203034 10/25/2011 CITY OF CARMEL, INDIANA VENDOR: 00351400 Page 1 of 1 z ONE CIVIC SQUARE INDIANA FIRE CHIEFS ASSN. CHECK AMOUNT: $525.00 CARMEL, INDIANA 46032 P 0 Box 364 o� ZIONSVILLE IN 46077 CHECK NUMBER: 203034 CHECK DATE: 10/2512011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4355300 525.00 ORGANIZATION MEMBER 2012 IFCA Membership Invoice Summary F s� INDIANA FIRE CHIEFS ASSOCIATION 9 0 To: Carmel Fire Department ti?FO sEPtEM�ePmry 2 Civic Square Carmel, IN 46032 Phone: 317- 571 -2600 Fax: 317- 571 -2615 Population Served: Dept. Type and Size (Career /Vol /Combin) Member Type Dues State Senate District: US Congress District: Department Budget Active (1st two Chiefs, any rank) $75 each State Rep District: IDHS District: 5 Active (Addt'I Chiefs, any rank)' $50 each Departmental (<30 in Dept, all ranks) $100 total In 2011, the individuals listed below with your department were members of the Indiana Fire Chiefs Association. Associate( >30, Non Chief or Other) $50 each We certainly hope those of you who were 2011 members will renew and encourage others in your department to Section Dues (EMS, Aviation, Public $25 each join as well in 2012. Please call with any questions concerning membership rates. Safety Educators, Technical Rescue) Note: We request that you review and correct this summary (especially blanks above). Mutual Aid Section no charge Please change online or fax, email or mail to Terry Rake, Executive Director IFCA. U ES 1. Fire Chief Keith Smith ksmith @carmel.in.gov Active $0.00 $75.00 Section (s): 2. Assistant Fire Chief David Haboush dhaboush @carmel.in.gov. Active $0.00 $75.00 Section (s): 3. Assistant Fire Chief Matt Hoffman mhoffman @carmel.in.gov Active $25.00 $50.00 Section (s): T To Add A New Member: To Remove A Member: To Change Data: Please add on this form the new members name, rank and Please note on the summary which member will not be Please change or add information to email address and determine any additional dues that may renewing and adjust the amount due by referring to the the data fields on this form. Attach be owed. membership dues structure. sheet if several changes IFCA Membership Application I P.O. Box 364 1 Zionsville, IN 46077 1 rake @indfirechiefs.org TEL: 1-(877) 733 -1850 1 FAX: (3 1 7) 733 -4212 1 www.indfirechiefs.org 7 012 IFCA Membership Invoice Summary PECNIEFy F` 9 S INDIANA FIRE CHIEFS ASSOCIATION i Carmel Fire Department TO ZF� SEPKMO° 2 Civic Square Carmel, IN 46032 4. Chief Jeff Steele jsteele @carmel.in.gov Active $0.00 $50.00 Section (s): S. EMS Chief Mark Hulett mhulett @carmel.in.gov Active $25.00 $50.00 Sectio (S): EMS Section 6. Public Education Keith Freer kfreer @carmel.in.gov Active $25.00 $50.00 Director Section (s): Public Safety Education Section 7. Fire Marshal Bruce Knott bknott @carmel.in.gov Active $25.00 $50.00 Section (s): Public Safety Education Section 8. Safety Chief Steve Reeves sreeves @carmel.in.gov Active $0.00 $50.00 Section (s): To Add A New Member: To Remove A Member: To Change Data: Please add on this form the new members name, rank and Please note on the summary which member will not be Please change or add information to email address and determine any additional dues that may renewing and adjust the amount due by referring to the the data fields on this form. Attach be owed. membership dues structure. sheet if several changes IFCA Membership Application I P.O. Box 364 1 Zionsville, IN 46077 1 rake @indfirechiefs.org TEL: 1-(877) 733 -1850 1 FAX: (3 1 7) 733 -4212 1 www.indfirechiefs.org 2012 IFCA Membership invoice Summary P E��EF S so INDIANA F IRE CHIEFS ASSOCI T O: Carmel Fire Department ryZ sEpTEk ^0ry 2 Civic Square Carmel, IN 46032 Please Send Receipt: El Check(payable to IFCA) Renewal Total: $450.00 V isa Mastercard Card Number: Section Dues: $4.944)A New Members: Name on Card: Exp Date: Signature Total Due: =Onfine Payment Option Visit: www.indfirechiefs.org under the membership tab New Members (write name, rank, email and any section changes below or submit changes online): T� Add A New Member: To Remove A Member: To Change Data: A� tease add on this form the new members name, rank and Please note on the summary which member will not be Please change or add information to ail address and determine any additional dues that may renewing and adjust the amount due by referring to the the data fields on this form. Attach owed. membership dues structure. sheet if several changes IFCA Membership Application I P.O. Box 364 1 Zionsville, IN 46077 1 rake @indfirechiefs.org TEL: 1-(877) 733 -1850 1 FAX: (3 1 7) 733 -4212 1 www.indfirechiefs.org Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) $525.00 1 hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance with IC 5- 11- 10 -1.6 20 Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 I FCA Indiana Fire Chiefs Association IN SUM OF P.O. Box 364 Zionsville, IN 46077 $525.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1120 I I 43- 553.00 I $525.00 1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except OCT 2 4 2011 f Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund